Survival after acute lymphocytic leukaemia: effects of socioeconomic status and geographic region

National cancer registry data, linked to an areal measure of material depri vation, were used to explore possible socioeconomic and regional variation in the surivival of children (0-14 years) diagnosed with acute lymphocytic leukaemia (ALL) in England and Wales from 1971 to 1990. Survival analysis a nd Poisson regression were used to estimate observed (crude) survival proba bilities and the adjusted hazard of death. There was little evidence of a s ocioeconomic gradient in survival. Regional differences in survival were ob served over time. These differences were most pronounced in the first six m onths after diagnosis, and may be attributable to differential access to ce ntralised paediatric oncology services or treatment protocols, or to the ar tefact of variations in regional cancer registry practice. Similar analyses should be repeated for other, less treatable childhood,cancers. The result s of this study can be used to help identify ways of reducing regional vari ation in survival.